Öz
Giriş: Kan transfüzyonu, çeşitli tıbbi durumlarda hayat kurtarıcı, ancak yüksek riskli bir işlem olup basit bir sıvı infüzyonu değil, bir organ naklidir. Kan transfüzyonu hayat kurtarıcı olsa da hayati tehlikeye yol açan ciddi reaksiyonlara neden olabilir. Günümüzde, kan ürünlerinin lökosit içeriklerinin azaltılması ya da ışınlanması ile reaksiyon sayıları ciddi oranda azalmıştır.
Gereç ve Yöntem: Çalışmamızda 14.08.2020 ile 17.02.2023 tarihleri arasında hastanemizde ışınlanmış kan ürünü alan toplam 5582 hasta dahil edildi. Eritrosit süspansiyonu, trombosit aferezi ve havuzlamış trombosit süspansiyonu 25-30 Gy’lik dozlar halinde ışınlanarak hastalara verildi.
Bulgular: Çalışmamızda 4990 eritrosit süspansiyonu, 282 havuzlanmış trombosit süspansiyonu, 310 trombosit aferezi olmak üzere toplam adet 5582 kan ürünü ışınlandı. Çalışmaya dahil edilen hiçbir hastada transfüzyon ilişkili Graft Versus Host Hastalığı saptanmamış olup, sadece hafif alerjik reaksiyon ve febril non-hemolitik transfüzyon reaksiyonları saptanmıştır.
Sonuçlar: Çalışmamızdan elde edilen veriler doğrultusunda, kan ürünlerinin ışınlanması ile son derece ölümcül olan transfüzyon ilişkili Graft Versus Host Hastalığının önlenebileceği sonucuna vardık.
Anahtar Kelimeler
: Işınlanmış kan ürünü kan transfüzyonu reaksiyon transfüzyon ilişkili Graft Versus Host Hastalığı
Destekleyen Kurum
Sivas Cumhuriyet Üniversitesi Bilimsel Araştırma Projeleri koordinasyon birimi (CÜBAP)
Proje Numarası
RGD-035
Teşekkür
Destekleri için Sivas Cumhuriyet Üniversitesi Bilimsel Araştırma Projeleri koordinasyon birimine teşekkür ediyorum
Kaynakça
- 1. Karadoğan İ. Transfüzyon komplikasyonları. Bayık M, editör. Kan bankacılığı, transfüzyon tıbbı ve aferez. Hematolog; 2015.s128-140.
- 2. Jawa RS, Young DH, Stothert JC, Kulaylat MN, Landmark JD. ‘Transfusion-associated graft versus host disease in the immunocompetent patient: An ongoing problem’, Journal of Intensive Care Medicine, 2015;30(3), pp. 123–130.
- 3. LS Del Lama, E Garcia de Go´ es, PC Dias Petchevist, EL Moretto, JC Borges, DT Covas, A de Almeida. Prevention of Transfusion-Associated Graft-versus-Host Disease by Irradiation: Technical Aspect of a New Ferrous Sulphate Dosimetric System. PLoS One. 2013 Jun 7;8(6):e65334. doi: 10.1371/journal.pone.0065334.
- 4. Chun S, Phan MTT, Hong S, Yang J, Yoon Y, Han S, Kang J, Yazer MH, Kim J, Cho D. Double-filtered leukoreduction as a method for risk reduction of transfusion-associated graft-versus-host disease.PLoS One. 2020; 15(3): e0229724. doi: 10.1371/journal.pone.0229724.
- 5. Kleinman S. and Stassinopoulos A. ‘Transfusion-associated graft-versus-host disease reexamined: potential for improved prevention using a universally applied intervention’, Transfusion. 2018:58(11), pp. 2545–2563. [PubMed: 30267423].
- 6. Şencan M. Lökosit Azaltılmış ve Işınlanmış Kan Ürünü Kullanımı. Türkiye Klinikleri J Int Med Sci 2007, 3(36):82-86.
- 7. Schroeder ML. Transfusion-associated graft-versus-host disease. Br J Haematol 2002;117:275-287.
- 8. Treleaven J, Gennery A, Marsh J, Norfolk D, Page L, Parker A, Saran F, Thurston J, Webbet D. Guidelines on the use of irradiated blood components prepared by the British Committee for Standards in Haematology blood transfusion task force. British Journal of Haematology. 2010: 152: 35–51.
- 9. AABB (2011) Standards for blood banks and transfusion services. 27th ed.Technical report, American Association of Blood Banks, Bethesda, MD, EUA.
- 10. Asai, T, Inaba S, Ohto H, Osada K, Suzuki G, Takahashi K, Tadokoro K, Minami M. Guidelines for irradiation of blood and blood components to prevent post-transfusion graft-vs-host disease in Japan. Transfus Med 2000;10:315-320.
- 11. Ruhl H, Bein G, Sachs UJ. Transfusion-associated graft-versus-host disease. ¨Transfus Med Rev. 2009;23(1):62–71.
- 12. Sprent J, Anderson RE, Miller JF. Radiosensitivity of T and B lymphocytes, II: effect of irradiation on response of T cells to alloantigens. Eur J Immunol. 1974; 4(3):204–10.
- 13. Button L, DeWolf W, Newburger P, Jacobson M, Kevy S. The effects of irradiation on blood components. Transfusion. 1981;21(4):419–426.
- 14. Valerius N, Johansen K, Nielsen O, Platz P, Rosenkvist J, Srensen H. Effect of in vitro X-irradiation on lymphocyte and granulocyte function. Scand J Haematol. 1981;27(1):9–18.
- 15. Fung MK, Grossman BJ, Hillyer C, Westhoff CM. AABB Technical Manual. 18th ed. Bethesda, MD: American Association of Blood Banks; 2014.
- 16. Serrano K. Chen D, Hansen AL, Levin E, Turner TR, Kurach JDR, Acker JP, Devine DV. ‘The effect of timing of gamma-irradiation on hemolysis and potassium release in leukoreduced red cell concentrates stored in SAGM.’, Vox Sanguinis.2014;106(4), pp. 379– 381. [PubMed: 24330144].
- 17. Morrison Doug (NAC-CCNMT Irradiation Working Group, Prokopchuk-Gauk Oksana, Devine Dana, Lane Debra, Laroche Vincent, Muirhead Brian, Nahirniak Susan, Rajappannair Lakshmi, Robitaille N ‘Recommendations for use of irradiated blood components in Canada, A NAC and CCNMT Collaborative Initiative’, 2018; pp. 9–10.
Öz
Background: Blood transfusion is a life-saving but high-risk procedure in various medical conditions as it is not a simple fluid infusion but an organ transplant. Although blood transfusions save lives, they may cause serious, life-threatening reactions. Nowadays, the number of reactions has decreased significantly with the reduction of leucocyte content of blood products or their irradiation.
Materials and Method: A total of 5582 patients who received irradiated blood products in our hospital between 14/08/2020 and 17/02/2023 were included in the present study. Erythrocyte suspension, platelet apheresis, and pooled platelet suspension were irradiated at doses of 25–30 Gy.
Results: A total of 5582 blood products including 4990 erythrocyte suspensions, 282 pooled platelet suspensions, and 310 platelet apheresis were irradiated in the present study. No transfusion-associated Graft Versus Host Disease was identified in any patient included in the present study and there were only mild allergic reactions and febrile non-hemolytic transfusion reactions.
Conclusions: Based on the data obtained here from, it was concluded that irradiation of blood products can prevent the highly fatal transfusion-related Graft Versus Host Disease.
Anahtar Kelimeler
Irradiated blood product blood transfusion reaction transfusion-associated Graft Versus Host Disease
Proje Numarası
RGD-035
Kaynakça
- 1. Karadoğan İ. Transfüzyon komplikasyonları. Bayık M, editör. Kan bankacılığı, transfüzyon tıbbı ve aferez. Hematolog; 2015.s128-140.
- 2. Jawa RS, Young DH, Stothert JC, Kulaylat MN, Landmark JD. ‘Transfusion-associated graft versus host disease in the immunocompetent patient: An ongoing problem’, Journal of Intensive Care Medicine, 2015;30(3), pp. 123–130.
- 3. LS Del Lama, E Garcia de Go´ es, PC Dias Petchevist, EL Moretto, JC Borges, DT Covas, A de Almeida. Prevention of Transfusion-Associated Graft-versus-Host Disease by Irradiation: Technical Aspect of a New Ferrous Sulphate Dosimetric System. PLoS One. 2013 Jun 7;8(6):e65334. doi: 10.1371/journal.pone.0065334.
- 4. Chun S, Phan MTT, Hong S, Yang J, Yoon Y, Han S, Kang J, Yazer MH, Kim J, Cho D. Double-filtered leukoreduction as a method for risk reduction of transfusion-associated graft-versus-host disease.PLoS One. 2020; 15(3): e0229724. doi: 10.1371/journal.pone.0229724.
- 5. Kleinman S. and Stassinopoulos A. ‘Transfusion-associated graft-versus-host disease reexamined: potential for improved prevention using a universally applied intervention’, Transfusion. 2018:58(11), pp. 2545–2563. [PubMed: 30267423].
- 6. Şencan M. Lökosit Azaltılmış ve Işınlanmış Kan Ürünü Kullanımı. Türkiye Klinikleri J Int Med Sci 2007, 3(36):82-86.
- 7. Schroeder ML. Transfusion-associated graft-versus-host disease. Br J Haematol 2002;117:275-287.
- 8. Treleaven J, Gennery A, Marsh J, Norfolk D, Page L, Parker A, Saran F, Thurston J, Webbet D. Guidelines on the use of irradiated blood components prepared by the British Committee for Standards in Haematology blood transfusion task force. British Journal of Haematology. 2010: 152: 35–51.
- 9. AABB (2011) Standards for blood banks and transfusion services. 27th ed.Technical report, American Association of Blood Banks, Bethesda, MD, EUA.
- 10. Asai, T, Inaba S, Ohto H, Osada K, Suzuki G, Takahashi K, Tadokoro K, Minami M. Guidelines for irradiation of blood and blood components to prevent post-transfusion graft-vs-host disease in Japan. Transfus Med 2000;10:315-320.
- 11. Ruhl H, Bein G, Sachs UJ. Transfusion-associated graft-versus-host disease. ¨Transfus Med Rev. 2009;23(1):62–71.
- 12. Sprent J, Anderson RE, Miller JF. Radiosensitivity of T and B lymphocytes, II: effect of irradiation on response of T cells to alloantigens. Eur J Immunol. 1974; 4(3):204–10.
- 13. Button L, DeWolf W, Newburger P, Jacobson M, Kevy S. The effects of irradiation on blood components. Transfusion. 1981;21(4):419–426.
- 14. Valerius N, Johansen K, Nielsen O, Platz P, Rosenkvist J, Srensen H. Effect of in vitro X-irradiation on lymphocyte and granulocyte function. Scand J Haematol. 1981;27(1):9–18.
- 15. Fung MK, Grossman BJ, Hillyer C, Westhoff CM. AABB Technical Manual. 18th ed. Bethesda, MD: American Association of Blood Banks; 2014.
- 16. Serrano K. Chen D, Hansen AL, Levin E, Turner TR, Kurach JDR, Acker JP, Devine DV. ‘The effect of timing of gamma-irradiation on hemolysis and potassium release in leukoreduced red cell concentrates stored in SAGM.’, Vox Sanguinis.2014;106(4), pp. 379– 381. [PubMed: 24330144].
- 17. Morrison Doug (NAC-CCNMT Irradiation Working Group, Prokopchuk-Gauk Oksana, Devine Dana, Lane Debra, Laroche Vincent, Muirhead Brian, Nahirniak Susan, Rajappannair Lakshmi, Robitaille N ‘Recommendations for use of irradiated blood components in Canada, A NAC and CCNMT Collaborative Initiative’, 2018; pp. 9–10.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Sistemleri |
| Bölüm | Dahili Tıp Bilimleri Araştırma Yazıları |
| Yazarlar | |
| Proje Numarası | RGD-035 |
| Erken Görünüm Tarihi | 30 Haziran 2023 |
| Yayımlanma Tarihi | 30 Haziran 2023 |
| Kabul Tarihi | 24 Haziran 2023 |
| Yayımlandığı Sayı | Yıl 2023Cilt: 45 Sayı: 2 |
